Ultrasound in case of suspected pancreatitis is performed to determine if the patient has this disease. If there is, then a chronic or acute form? And also in order to, after examining the pancreas, to understand what complications threaten the patient. Among the most frequent complications are thrombosis of veins or arteries of the spleen, abscesses, fluid accumulation, tumors, false cysts, gallstones. Due to the absence of contraindications and the possibility to examine the pancreas in three planes, ultrasound is considered a valuable method for evaluating all processes occurring in the gland.
The direction of the patient on ultrasound with suspicion of pancreatitis is an excellent way to determine by visible signs what form of the disease is observed in the patient, since the sonographic symptoms in acute and chronic forms are significantly different.
It is also important to note that pancreatitis may not be visible if ultrasound is performed at an early stage of its development or is of an easy nature. In the acute course of the disease on ultrasound, there are signs of a decrease in the echogenicity of the gland and the fuzziness of its contours. This allows you to better consider the pancreas itself, but its outlines will thin out along with the progression of destructive-inflammatory processes. Explicit signs of acute pancreatitis: an enlarged pancreatic duct, thinned soft tissues, heterogeneity of the pancreas and a wide limit of reduced echolar density of the gland. With ultrasound diagnosis, both focal and diffuse features can be seen.
With a chronic form of the disease, ultrasound may not show any signs of the disease. If the patient has an enlarged duct and a decrease in echogenicity in combination with an enlarged gland, this often indicates the onset of the development of chronic pancreatitis. Along with the progression of the disease, there will be diffuse or focal increases in the pancreas, the transformation of the gland into a heterogeneous region with highly echogenic regions. Often on ultrasound, foci of hypoechogenic tissues and pseudocysts are seen. The contour of the pancreas becomes small-hummocky with serrated areas.
In later stages, ultrasonography of chronic pancreatitis will show signs of pancreatic atrophy, puckering and fibrosity of the organ, which makes the gland visually small with an enlarged pancreatic duct.
Conclusion on ultrasound of the pancreas with pancreatitis
Unfortunately, it can be noted with certainty that only ultrasound of the pancreas for pancreatitis is not enough. Especially it concerns the initial stages of the disease. If the inflammation is not clearly expressed, then the conclusion of an ultrasound in pancreatitis can be absolutely normal. Even the chronic form of this disease can be detected only with the help of ultrasound diagnostics, sometimes, it is difficult or, simply, impossible. Zones of uneven changes in echomolarity prevent the visualization of the organ.
In general, ultrasound determines the size of the organs, their shape and contours, the presence or absence of any changes. Gases that are in the human intestine can significantly worsen the interpretation of results and mislead even professional health professionals. Therefore, always with the ultrasound of the pancreas should be assigned additional studies, according to the results of which it will be much easier to make a complete picture of the course of the disease. In especially difficult cases, computer tomography and ERCP can be prescribed( endoscopic retrograde cholangiopancreatography).Sometimes only by combining several methods at the same time, one can give a complete and correct conclusion about the disease, and, therefore, prescribe a more effective treatment.